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Anti-metabolites
Nivolumab + Methotrexate/5-Azacytidine for Recurrent Brain Tumors
Phase 1
Recruiting
Led By David I. Sandberg, MD
Research Sponsored by David Ilan Sandberg
Eligibility Criteria Checklist
Specific guidelines that determine who can or cannot participate in a clinical trial Must have
Age 1 - 80 years at time of recurrence or progression
Minimum body weight of 10 kilograms
Must not have
Patient that has had allogenic stem cell transplant
Timeline
Screening 3 weeks
Treatment Varies
Follow Up from start of treatment to end of treatment (about 12 weeks)
Awards & highlights
Summary
"This trial aims to test the safety and effectiveness of using nivolumab with 5-azacytidine for recurrent ependymoma, and nivolumab with methotrexate
Who is the study for?
This trial is for people with recurrent brain tumors like medulloblastoma and ependymoma. Participants should have a tumor that can be measured, no prior immunotherapy, and adequate organ function. They must not have an active infection or another cancer, be pregnant, or have had recent surgery.
What is being tested?
The study tests the safety and tumor-fighting ability of nivolumab (an immune system booster) combined with either methotrexate or 5-azacytidine (chemotherapy drugs), delivered directly into the fourth ventricle of the brain to treat recurring brain tumors.
What are the potential side effects?
Possible side effects include inflammation in various organs due to immune response, infusion-related reactions from nivolumab; liver toxicity and mouth sores from methotrexate; nausea, low blood cell counts leading to increased infection risk from 5-azacytidine.
Eligibility Criteria
Inclusion Criteria
You may be eligible if you check “Yes” for the criteria belowSelect...
I am between 1 and 80 years old and my cancer has come back or gotten worse.
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I weigh at least 10 kilograms.
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I have or agree to get a catheter placed for my brain tumor treatment.
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I am mostly active and can do most of my daily activities.
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I haven't taken any cancer treatment drugs or experimental drugs in the last 7 days.
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I have recovered from the side effects of my previous cancer treatments.
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I had specific cell or viral therapy over 3 months ago, or a stem cell transplant with no ongoing complications.
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My blood counts, liver, and kidney functions are within safe ranges for treatment.
Exclusion Criteria
You may be eligible for the trial if you check “No” for criteria below:Select...
I have had a stem cell transplant from a donor.
Timeline
Screening ~ 3 weeks3 visits
Treatment ~ Varies
Follow Up ~ from start of treatment to end of treatment (about 12 weeks)
Screening ~ 3 weeks
Treatment ~ Varies
Follow Up ~from start of treatment to end of treatment (about 12 weeks)
Treatment Details
Study Objectives
Outcome measures can provide a clearer picture of what you can expect from a treatment.Primary outcome measures
Safety as assessed by the number of participants with a new neurological toxicity that is graded as Grade 3 or higher and that is probably or definitely related to infusions [that is, classified as dose-limiting toxicity (DLT)]
Trial Design
2Treatment groups
Experimental Treatment
Group I: Nivolumab plus MethotrexateExperimental Treatment2 Interventions
Enrolled patients with medulloblastoma and other CNS malignancies will receive:
1. Intraventricular Methotrexate infusions 2 mg daily for 4 consecutive days per week every other week on weeks 1, 3, 5, 7, 9, and 11.
2. Intraventricular Nivolumab infusions. Nivolumab will be administered once every other week on weeks 2, 4, 6, 8, 10, and 12. Dosing will be based upon patient body weight.
Group II: Nivolumab plus 5-AzacytidineExperimental Treatment2 Interventions
Enrolled patients with ependymoma will receive:
1. Intraventricular 5-Azacytidine infusions 10 mg once weekly for twelve consecutive weeks.
2. Intraventricular Nivolumab infusions once every other week on weeks 1, 3, 5, 7, 9, and 11. Dosing will be based upon patient body weight.
Treatment
First Studied
Drug Approval Stage
How many patients have taken this drug
Nivolumab
2014
Completed Phase 3
~5220
5-Azacytidine
2015
Completed Phase 2
~270
Methotrexate
2019
Completed Phase 4
~4400
Find a Location
Who is running the clinical trial?
David Ilan SandbergLead Sponsor
David I. Sandberg, MDPrincipal InvestigatorThe University of Texas Health Science Center, Houston
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